Monday, August 03, 2009

Another perspective on Healthcare Costs

In my opinion the true issues regarding the costs associated with health care in the USA are not being addressed. As is usual in these politically charged debates, the true issues are not being addressed. Issues that fit ideological biases, or which seem to be populist are pursued without really taking the time to dig down to the root issues. It is almost like the old joke about "don't confuse me with the facts".

The crux of the current debate about health care seems to be about the large number of people in the USA who do not have health insurance. Some might argue that the uninsured to not have access to health care. Obviously everyone have access to primary health care. The emergency rooms treat anyone who walks in. The issue is not whether you can get treatment, but whether you can pay for it.

Unfortunately, emergency rooms are being abused by many people who do not have legitimate emergencies. Often, the patients in the ER are there for routine treatment because they do not have a insurance or are illegal aliens etc. In many situations, the ER has become a health care clinic.

An anecdote: A friend who is a nurse at a local ER told me of a situation where a patient used the emergency services (ambulance etc), to have a pregnancy test done. The person did not have the money to get a pregnancy test done elsewhere, but since she declared an emergency, the ambulance was used and the test was done. The cost for this incident was probably around $2000. This kind of abuse or the ER (in my view) is not an isolated case. People will find loopholes in every system.

Often hospitals treat uninsured patients in the ER at a loss. The loss is usually borne out by paying patients. As I mentioned in a previous post - altruism and the profit motive do not make good bedfellows.

The solution to the problem of uninsured patients is not giving everyone insurance and creating a huge (and expensive) bureaucracy to administer the insurance system.

A starting point for thinking about a solution must involve providing affordable primary health care (free in some cases) to those who cannot afford their own insurance. Primary health care should be easily available. People should not have to abuse the emergency system to get primary health care.

In a next post I will write about the cost of training doctors. After 11 years of medical training, the student loans could reach $300,000 in some cases.

4 comments:

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